Adelaide Institute for Sleep Health and Flinders Health and Medical Research Institute (FHMRI) Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, Australia (H.S., B.L., A.G., A.C.R., N.L., G.N., S.A., R.A., P.C., D.J.E.).
Centre Interdisciplinaire du Sommeil, Paris, France (P.E.).
Hypertension. 2023 May;80(5):1117-1126. doi: 10.1161/HYPERTENSIONAHA.122.20513. Epub 2023 Mar 28.
Irregularities in sleep duration and sleep timing have emerged as potential risk factors for hypertension. This study examined associations between irregularity in sleep duration and timing with hypertension in a large, global sample over multiple months.
Data from 12 287 adults, who used an under-mattress device to monitor sleep duration and timing and also provided blood pressure recordings on ≥5 separate occasions, were analyzed. Sleep duration irregularity was assessed as the SD in total sleep time across the ≈9-month recording period. Sleep timing irregularity was assessed as SDs in sleep onset time, sleep midpoint, and sleep offset time. Logistic regressions were conducted to investigate associations between sleep irregularity and hypertension, defined as median systolic blood pressure ≥140 mm Hg or median diastolic blood pressure ≥90 mm Hg.
Participants were middle-aged (mean±SD, 50±12 years), mostly men (88%) and overweight (body mass index, 28±6 kg/m). Sleep duration irregularity was consistently associated with an ≈9% to 17% increase in hypertension independently of the total sleep time. A ≈34-minute increase in sleep onset time irregularity was associated with a 32% increase in hypertension (1.32 [1.20-1.45]). A 32-minute increase in sleep midpoint irregularity was associated with an 18% increase in hypertension (1.18 [1.09-1.29]), while a 43-minute increase in sleep offset time irregularity was associated with an 8.9% increase in hypertension (1.09 [1.001-1.18]).
These findings support that sleep irregularity, both in duration and timing, is a risk marker for poor cardiovascular health. Further mechanistic investigations of temporal relationships between day-to-day fluctuations in sleep duration and timing, next-day blood pressure, and other cardiovascular outcomes are warranted.
睡眠时长和睡眠时相不规律已成为高血压的潜在危险因素。本研究在长达数月的时间里，在一个大型全球样本中，研究了睡眠时长和时相不规律与高血压之间的关联。
对使用床垫下设备监测睡眠时长和时相并在≥5 个不同时间点提供血压记录的 12287 名成年人的数据进行了分析。睡眠时长不规律的评估指标为约 9 个月记录期间总睡眠时间的标准差。睡眠时相不规律的评估指标为睡眠起始时间、睡眠中点和睡眠结束时间的标准差。采用 logistic 回归分析来调查睡眠不规律与高血压（定义为收缩压中位数≥140mmHg 或舒张压中位数≥90mmHg）之间的关联。
参与者年龄在 50±12 岁（平均±标准差），大多数为男性（88%）和超重（体重指数 28±6kg/m²）。不论总睡眠时间如何，睡眠时长不规律均与高血压风险增加约 9%至 17%独立相关。睡眠起始时间不规律增加约 34 分钟，与高血压风险增加 32%相关（1.32[1.20-1.45]）。睡眠中点不规律增加 32 分钟，与高血压风险增加 18%相关（1.18[1.09-1.29]），而睡眠结束时间不规律增加 43 分钟，与高血压风险增加 8.9%相关（1.09[1.001-1.18]）。
这些发现支持睡眠不规律（无论是时长还是时相）均是心血管健康不良的风险标志物。需要进一步开展关于日间睡眠时长和时相波动与次日血压和其他心血管结局之间的时间关系的机制研究。
